Gastrointestinal toxicity and its relation to dose distributions in the anorectal region of prostate cancer patients treated with radiotherapy
Gastrointestinal toxicity and its relation to dose distributions in the anorectal region of prostate cancer patients treated with radiotherapy
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DOI：
10.1016/j.ijrobp.2004.07.724
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发表时间：
2005-03-15
影响因子：
7
通讯作者：
Koper, PCM
中科院分区：
文献类型：
--
作者：
Heemsbergen, WD;Hoogeman, MS;Koper, PCM
目的：研究肛门直肠区域的剂量分布与局部前列腺癌治疗患者的晚期胃肠道症状之间的相关性。方法和材料：分析随机研究的数据。在这项试验中，患者接受了剂量为 66 Gy 的矩形或适形射野治疗。有关胃肠道症状的数据是从 197 名患者的问卷中收集的。将肛门直肠区域的分布投影在地图上，并计算剂量参数。使用比例风险回归模型，将投诉发生率作为剂量面积参数和临床参数的函数进行研究。最后，我们测试了来自肛门直肠区域不同部位的一系列剂量参数。结果：分析整个区域，仅发现出血的统计显着剂量-面积效应关系（p < 0.01）。通过定义分区，我们发现了出血、弄脏、大便失禁和粘液流失的效应关系。对于出血和粘液流失，发现肛门直肠上部 70-80% 区域接受的剂量相关性最强 (p < 0.01)。对于弄脏和大便失禁，我们发现与较低 40-50% 的剂量相关性最强 (p < 0.05)。结论：我们发现证据表明不适源自受照射的下胃肠道的特定区域。出血和粘液流失可能与直肠上部的照射有关。弄脏和大便失禁更可能与肛管和直肠下部的剂量有关。 (c) 2005 年爱思唯尔公司。
Purpose: To study the correlations between-the dose distributions in the anorectal region and late GI symptoms in patients treated for localized prostate carcinoma.Methods and Materials: Data from a randomized study were analyzed. In this trial, patients were treated with either rectangular or conformal fields with a dose of 66 Gy. Data concerning GI symptoms were collected from questionnaires of 197 patients. The distributions of the anorectal region were projected on maps, and the dose parameters were calculated. The incidences of complaints were studied as a function of the dose-area parameters and clinical parameters, using a proportional hazard regression model. Finally, we tested a series of dose parameters originating from different parts of the anorectal region.Results: Analyzing the total region, only a statistically significant dose-area effect relation for bleeding was found (p < 0.01). Defining subareas, we found effect relations for bleeding, soiling, fecal incontinence, and mucus loss. For bleeding and mucus loss, the strongest correlation was found for the dose received by the upper 70-80% of the anorectal region (p < 0.01). For soiling and fecal incontinence, we found the strongest association with the dose to the lower 40-50% (p < 0.05).Conclusion: We found evidence that complaints originate from specific regions of the irradiated lower GI tract. Bleeding and mucus loss are probably related to irradiation of the upper part of the rectum. Soiling and fecal incontinence are more likely related to the dose to the anal canal and the lower part of the rectum. (c) 2005 Elsevier Inc.